Going off the Rails

Why One Family Physician is Fighting For a Ban on Alcohol Ads in our Transit System

[previously published in the NY Daily News]

It’s time to clean up the New York City transit system. No, I’m not a sanitation worker or a police officer — I’m a family physician who wants to help people live the longest, healthiest lives possible, and who realizes that exposures in our transit system are making people sick.

I’m not talking about exposures to rats or grime or infectious diseases. I’m talking about exposures to something more subtle but just as sinister: alcohol ads. These ads are so common that you might not even notice them, or at least not think that you do.

But people do notice alcohol ads, and they convincingly cause harm. The ads are linked to intentions to drink alcohol and then to too much drinking, especially in young people.

Excessive drinking contributes to high blood pressure, liver and heart disease, a multitude of cancers, and poor mental health. It also has the power to ruin careers and break up families.

According to the New York City Department of Health, more than 135,000 New Yorkers are admitted to hospitals for treatment of alcohol use disorders every year, and 70,000 emergency room visits are alcohol-related. Harmful alcohol use costs the city $6 billion a year in lost productivity alone.

As a family physician, I witness the consequences of excessive alcohol use in patients every day, often at ages far too young. It seems incredibly unfair that these consequences unduly affect patients who are foreign-born, lower-income, racial and ethnic minorities.

Such patients also happen to be the exact same people transit alcohol ads target, with a misleading message that alcohol is for healthy people enjoying happy lives.

Maybe you haven’t paid attention to these ads. But as a doctor, I can’t ignore them. In fact, I’ve analyzed them in detail. Working with my colleagues from Montefiore Health System and Albert Einstein College of Medicine, I conducted a study looking at food-and-beverage advertising in subway lines running throughout the Bronx.

My team rode all lines, stopped in all stations and looked closely at the more than 1,500 ads on display in 68 stations and in all seven subway lines running through the Bronx. We then linked our observations to data on subway ridership and to demographic and health data for the neighborhoods in which stations were located.

What we found was alarming. Ads for alcohol were disproportionately located in stations serving neighborhoods with higher poverty, lower high school graduation rates, higher proportions of Hispanic residents, and higher percentages of children.

And the messages weren’t directed at the largest possible audiences; they were targeted at specific groups: vulnerable groups ... groups like my patients.

Just as alarming as what we found in our study is what we didn’t find. There were precisely zero ads promoting healthier foods or beverages like fruits, vegetables, whole grains, nuts, milk or water. Instead, we found plenty of ads promoting unhealthy items like candies, chips, sugary cereals, frozen pizza and alcohol.

More than a third of the stations having advertising for “less-healthful” foods or beverages (39%) had such ads in Spanish (the only foreign language observed). More than a third (39%) had “less-healthful” ads featuring minorities, and greater than a quarter (26%) had less-healthful ads directed at youth.

We don’t allow alcohol ads in our schools. Why would we allow children to stare at them on our buses and subways as they ride to and from school?

This Wednesday (10-25-17), the MTA’s Board of Directors is scheduled to vote on a proposal to eliminate alcohol advertising from all transit vehicles and properties. Such a ban is already in effect in other great U.S. cities: e.g., Boston, Philadelphia, Baltimore, Los Angeles, San Francisco, Oakland, San Diego, Sacramento and Seattle.

New York, with its sprawling subway system and staggering health challenges related to alcohol use, should join these other metropolitan areas.

Too many people, especially vulnerable people, suffer too much from alcohol-related health problems. It’s past time for us to take a stand so that not only my patients, but all citizens and New York visitors, can travel to and from all the great destinations the city has to offer, free of exposure to something that has the power to do so much damage.